ABSTRACT
There is a growing recognition that emotional problems are important to physical health outcomes. In response, primary care clinics have introduced self-report checklists to identify patients with emotional disorders such as depression or anxiety. Yet psychodynamic theory posits that certain emotional problems may be unconscious and unspoken, and thus not discernible on self-report checklists, and studies show that checklists do not identify every patient who needs treatment. New clinical tools are needed to identify subtle and complex presentations. We aimed to develop an innovative mixed-methods approach characterizing different types of verbal expression of feelings, drawing on psychodynamic theory and empirical research. We outline the development of the mixed-methods approach, including our theoretical framework and use of semi-structured interview data from Partners in Care (PIC), a randomized controlled trial of quality improvement for depression. We then illustrate the approach with one case: an older female PIC participant who screened positive for depression on all study self-reports. The approach delineates three qualitatively different categories of words-specific feeling words, vague feeling words, and physical words-that were quantified to define a measurable pattern for our participant. Clinicians could be trained to identify these categories of words in the context of a discussion of feelings to better detect and understand subtle emotional problems in patients who have difficulty talking openly about their feelings. Next steps include furthering face and construct validity and test-retest reliability, examining the prevalence of these patterns in a larger sample, and assessing correlates of patterns.
Subject(s)
Antidepressive Agents/therapeutic use , Depressive Disorder, Major , Emotions , Patient Care Management/methods , Physical Functional Performance , Psychotherapeutic Processes , Aged , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/physiopathology , Depressive Disorder, Major/psychology , Depressive Disorder, Major/therapy , Emotional Intelligence , Female , Humans , Interview, Psychological/methods , Medical History Taking/methods , Professional-Patient Relations , Psychological Techniques , Verbal BehaviorABSTRACT
Ethylene is the primary component in most plastics, making it economically valuable. It is produced primarily by steam-cracking of hydrocarbons, but can alternatively be produced by the dehydration of ethanol, which can be produced from fermentation processes using renewable substrates such as glucose, starch and others. Due to rising oil prices, researchers now look at alternative reactions to produce green ethylene, but the process is far from being as economically competitive as using fossil fuels. Many studies have investigated catalysts and new reaction engineering technologies to increase ethylene yield and to lower reaction temperature, in an effort to make the reaction applicable in industry and most cost-efficient. This paper presents various lab synthesized catalysts, reaction conditions, and reactor technologies that achieved high ethylene yield at reasonable reaction temperatures, and evaluates their practicality in industrial application in comparison with steam-cracking plants. The most promising were found to be a nanoscale catalyst HZSM-5 with 99.7% ethylene selectivity at 240 °C and 630 h lifespan, using a microreactor technology with mechanical vapor recompression, and algae-produced ethanol to make ethylene.
